| NPI | 1760808935 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA OLIVE GASSAWAY Administrator 214-668-0414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX 604322) |
| Enumeration Date | 2014-03-12 |
| Last Update Date | 2024-03-18 |